Journal of Hand Surgery RSS feed. https://www.jhandsurg.org/issues?journalCode=yjhsu&publicationCode=yjhsu&rss=yes Elsevier Inc. en © 2026 Published by Elsevier Inc. All rights reserved. Journal of Hand Surgery 0363-5023 2026-08-17-07:00 © 2026 Published by Elsevier Inc. All rights reserved. permissionshelpdesk@elsevier.com https://www.jhandsurg.org/article/S0363-5023(26)00363-1/fulltext?rss=yes To identify radiographic risk factors for flexor tendon ruptures following volar distal radius plating. Radiographic Risk Factors for Flexor Tendon Ruptures Following Distal Radius Volar Plating Abdo Bachoura, Jonas Matzon, Kassem Ghayyad, Temitope Ayodele, Pedro Beredjiklian, Richard Tosti 10.1016/j.jhsa.2026.04.021 Journal of Hand Surgery (2026) 2026-08-17 Journal of Hand Surgery 2026-08-17 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00515-0/fulltext?rss=yes Brief intraoperative electrical nerve stimulation (ES) has shown potential to improve outcomes of peripheral nerve surgery, including nerve repair, grafting, and transfer. This study compares clinical outcomes of nerve transfers receiving ES to those that did not. Ten Minutes of Intraoperative Nerve Stimulation May Improve Outcomes Following End-to-End Nerve Transfer Madeline Rieker, Stephanie Choo, Katherine Snipes, V.V.N. Manohar Devarasetty, Henry Kuechly, Nicole Covell, Richard Arendale, Kennedy Gachigi, R. Glenn Gaston, Bryan J. Loeffler 10.1016/j.jhsa.2026.07.005 Journal of Hand Surgery (2026) 2026-08-13 Journal of Hand Surgery 2026-08-13 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00516-2/fulltext?rss=yes Proximal interphalangeal (PIP) joint osteoarthritis frequently causes pain and functional limitation. Arthroplasty and arthrodesis can provide pain relief but are invasive, require prolonged rehabilitation, and carry substantial complication risks. PIP joint denervation has emerged as a less invasive, motion-preserving alternative. However, evidence remains limited, and its durability is unclear. Is PIP Denervation for Osteoarthritis a Durable Solution? Results from a Multicenter Outcome Study Esmee Kwee, Niek J. Nieuwdorp, Camille Blaaker, Liron S. Duraku, J. Michiel Zuidam, The Hand-Wrist Study Group, Caroline A. Hundepool 10.1016/j.jhsa.2026.06.006 Journal of Hand Surgery (2026) 2026-08-11 Journal of Hand Surgery 2026-08-11 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00493-4/fulltext?rss=yes A single institution external validation study was conducted to evaluate the recently created Mangled Digit Severity Score (MDSS). We hypothesized that the MDSS would demonstrate good discriminatory ability in predicting amputation versus successful salvage in an independent external cohort of patients with mangled digital injuries. Single Institution Validation Study of the Mangled Digit Severity Score for Predicting Salvageability of Severe Digital Injuries Andrew A. Monhollen, Nash D. Kolb, Gillian Hark, Daniel A. London 10.1016/j.jhsa.2026.06.001 Journal of Hand Surgery (2026) 2026-08-11 Journal of Hand Surgery 2026-08-11 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00496-X/fulltext?rss=yes Gunshot wounds (GSWs) to the extremities can be debilitating because of their effect on peripheral nerves and the subsequent loss of function experienced by patients. However, intraoperative findings seen upon nerve exploration in ballistic injuries have not been widely reported in the civilian population. In this study, we examine our experience in the operative management of low-velocity civilian GSW injuries to the extremities with concomitant nerve palsies in regard to indications for exploration, intraoperative findings, and methods of reconstruction. Operative Evaluation and Treatment of Civilian Ballistic Nerve Injuries: A Case Series Kanad Ghosh, Sarthak Aggarwal, Ethan Blum, David M. Brogan, Christopher J. Dy, Jeffrey G. Stepan 10.1016/j.jhsa.2026.07.003 Journal of Hand Surgery (2026) 2026-08-07 Journal of Hand Surgery 2026-08-07 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00366-7/fulltext?rss=yes To evaluate the anatomical equivalence of the proximal articular surface of the capitate and the second metatarsal head as potential donor–recipient surfaces for lunocapitate reconstruction. An Anatomical Equivalence Study of the Capitate and the Second Metatarsal Head as a Donor for Lunocapitate Articular Reconstruction Hayato Kuno, Yukichi Zenke, Akinori Sakai 10.1016/j.jhsa.2026.05.001 Journal of Hand Surgery (2026) 2026-07-16 Journal of Hand Surgery 2026-07-16 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00307-2/fulltext?rss=yes Anthony Smith, MD, and Steve McCabe, MD, present a concise and engaging biography of Dr Sterling Bunnell, a figure widely recognized as the founder of modern hand surgery. Dr. Sterling Bunnell: From Son of the Gold Rush to Founding Father of Hand Surgery situates Dr Bunnell’s life within both the broader historical landscape of the late 19th- and early 20th-century America and the emergence of hand surgery as a distinct medical specialty. The book succeeds in offering a readable yet informative account that will appeal to surgeons, trainees, and readers interested in medical history. Dr. Sterling Bunnell: From Son of the Gold Rush to Founding Father of Hand Surgery Kevin J. Little 10.1016/j.jhsa.2026.04.002 Journal of Hand Surgery (2026) 2026-07-07 Journal of Hand Surgery 2026-07-07 Book Review https://www.jhandsurg.org/article/S0363-5023(26)00373-4/fulltext?rss=yes Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as semaglutide and tirzepatide, have rapidly increased in use for diabetes management and weight loss, coinciding with the rising prevalence of obesity and diabetes among patients undergoing hand surgery. Growing perioperative concerns of delayed gastric emptying and aspiration risk have prompted evolving guideline recommendations and clinical uncertainty surrounding surgical planning. Current evidence on GLP-1 RA usage and outcomes in hand and orthopedic literature remains limited, but multiple studies report no notable increase in postoperative complications. Current Concepts in Perioperative Guidance and Outcomes in Hand Surgery Patients Taking Glucagon-Like Peptide-1 Receptor Agonists Ethan Y. Song, M. Stephen Melton, Warren Hammert, Neill Y. Li, Eliana B. Saltzman 10.1016/j.jhsa.2026.05.008 Journal of Hand Surgery (2026) 2026-07-03 Journal of Hand Surgery 2026-07-03 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00419-3/fulltext?rss=yes Tendon-to-bone healing remains a major clinical challenge due to poor regenerative capacity at the enthesis. This study aimed to evaluate the effects of mesenchymal stem cell−derived exosomes combined with a 3-dimensional hyaluronan-based scaffold on graft healing within bone tunnels. This study was conducted in accordance with the ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines. Mesenchymal Stem Cell−Derived Exosomes Combined With 3-Dimensional Hyaluronan-Based Scaffold Promote Tendon-to-Bone Tunnel Healing Sergen Karatas, Gokce Yildiran, Gulsemin Cicek, Hande Akdeniz, Fatma Oz Bagci, Zekeriya Tosun 10.1016/j.jhsa.2026.05.009 Journal of Hand Surgery (2026) 2026-07-02 Journal of Hand Surgery 2026-07-02 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00425-9/fulltext?rss=yes This study aimed to compare the biomechanical properties of one-knot and two-knot configurations in eight-strand flexor tendon repair using looped sutures. The influence of knot-tying strategy on gap resistance and ultimate failure strength was evaluated using a standardized porcine Achilles tendon model. Comparison of One- and Two-knot Techniques in Eight-Strand Flexor Tendon Repair Using Looped Sutures: A Biomechanical Study in a Porcine Model Hideomi Takami, Hideyuki Ota, Satoshi Niwa, Hoyu Cho, Tomoyuki Tamemoto, Kazuki Uchibori 10.1016/j.jhsa.2026.05.015 Journal of Hand Surgery (2026) 2026-06-30 Journal of Hand Surgery 2026-06-30 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00421-1/fulltext?rss=yes Clenched fist syndrome is a rare psychosomatic condition that can cause great diagnostic and management challenges for hand surgeons. There is little published literature on the clinical characteristics and treatment of clenched fist syndrome. The limited evidence available discusses a wide range of clinical presentations and recommend inconsistent treatments. This causes confusion and uncertainty for surgeons managing a condition with a high level of complexity. This review aims to summarize existing literature that describes the diagnosis and management of clenched fist syndrome. The Diagnosis and Management of Clenched Fist Syndrome Niklaus P. Zeller, Jade M. Cohen, Sims Ma, Edward J. Wu 10.1016/j.jhsa.2026.05.011 Journal of Hand Surgery (2026) 2026-06-30 Journal of Hand Surgery 2026-06-30 The Hand Surgery Landscape https://www.jhandsurg.org/article/S0363-5023(26)00426-0/fulltext?rss=yes Conventional workhorse free flaps can be too thick for hand and upper-extremity reconstruction. Additionally, donor site scarring is often visible and bothersome to patients. This study aims to describe the technique for preoperative perforator mapping with color doppler ultrasound (CDU) and surgical technique for elevation of a thin posteromedial thigh or profunda artery perforator (PAP) flap. Additionally, a case series of patients who underwent the PAP free flap for reconstruction in the hand and upper extremity is reviewed. Ultrasound-Assisted Thin Posteromedial Thigh Free Flap for Coverage of Hand and Upper-Extremity Wounds Harvey Chim 10.1016/j.jhsa.2026.05.016 Journal of Hand Surgery (2026) 2026-06-29 Journal of Hand Surgery 2026-06-29 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00422-3/fulltext?rss=yes Carpal tunnel syndrome is one of the most prevalent upper-extremity disorders. It may present unilaterally, bilaterally, or on the contralateral hand at a subsequent time to initial carpal tunnel release (CTR). We aimed to assess the incidence, timing, and factors associated with contralateral CTR at the time of an index unilateral surgery. Incidence, Timing, and Predictors of Staged Contralateral Carpal Tunnel Release at Minimum Ten-Year Follow-Up from Unilateral Surgery Luna Toma, Rose Meng Gold, Ethan Cossu, Leah Demetri, Brandon E. Earp, Philip E. Blazar, Dafang Zhang 10.1016/j.jhsa.2026.05.012 Journal of Hand Surgery (2026) 2026-06-19 Journal of Hand Surgery 2026-06-19 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00321-7/fulltext?rss=yes Suture that approaches the strength of metal wire is now commonly used in many orthopedic applications. This study aimed to compare the strength of a suture and screw tension band fixation of olecranon fractures with the established method K-wire and metal tension band technique. Biomechanical Comparison of Metal Versus Suture and Screw Tension Band Technique for Olecranon Fractures David Kirby, Sorin Siegler, Mehrangiz Taheri, Luigi Piarulli, Harrison Fellheimer, Christopher Jones 10.1016/j.jhsa.2026.04.016 Journal of Hand Surgery (2026) 2026-06-19 Journal of Hand Surgery 2026-06-19 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00420-X/fulltext?rss=yes The goal of this study is to synthesize and critically evaluate nonsurgical and surgical strategies for upper limb reconstruction in arthrogryposis multiplex congenita across the shoulder, elbow, forearm, wrist, and thumb, and to develop an evidence-informed treatment algorithm. Upper Limb Reconstruction in Arthrogryposis Multiplex Congenita: A Systematic Review J. Terrence Jose Jerome, G. Surendran, K. Thirumagal 10.1016/j.jhsa.2026.05.010 Journal of Hand Surgery (2026) 2026-06-17 Journal of Hand Surgery 2026-06-17 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00372-2/fulltext?rss=yes The aim of this study was to evaluate the association between ganglion cysts and generalized joint hypermobility and to identify potential independent risk factors. Is Generalized Joint Hypermobility a Risk Factor in the Development of Wrist Ganglion Cysts? A Retrospective Case-Control Study Volkan Özel, İbrahim Halil Demir, Tuğrul Yıldırım 10.1016/j.jhsa.2026.05.007 Journal of Hand Surgery (2026) 2026-06-17 Journal of Hand Surgery 2026-06-17 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00369-2/fulltext?rss=yes Patients treated for Dupuytren contracture in one digit are at risk for future intervention in other digits or the contralateral hand. Identifying predictive factors can aid in patient counseling. The Likelihood of Future Dupuytren Disease Intervention After Initial Treatment in the Same Digit, Another Digit, and Contralateral Hand Rayan El Bachaoui, Ethan Cossu, Dafang Zhang, Brandon E. Earp, Philip E. Blazar 10.1016/j.jhsa.2026.05.004 Journal of Hand Surgery (2026) 2026-06-11 Journal of Hand Surgery 2026-06-11 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00371-0/fulltext?rss=yes The purpose of this study was to assess outcomes after treatment of scaphoid nonunion with open reduction internal fixation and nonvascularized autograft (NVA). Outcomes After Treatment of Scaphoid Nonunion With Open Reduction Internal Fixation and Nonvascularized Autograft Lynn Ann Forrester, Rafa Rahman, Raylin Xu, Michelle Carlson, Daniel Osei, Samir K. Trehan 10.1016/j.jhsa.2026.05.006 Journal of Hand Surgery (2026) 2026-06-08 Journal of Hand Surgery 2026-06-08 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00368-0/fulltext?rss=yes The degree to which motor and psychosocial functions may recover following hand and upper-extremity transplantation (HUET) remains unclear. This study quantifies HUET outcome changes in the first 10 years post-transplantation to provide insight into this question. Timeline of Functional Recovery Following Hand and Upper-Extremity Transplantation Isaac Mordukhovich, Connor Roncagli, Natalie Hoffner, Kyle Barclay, Antonio Rampazzo, Bahar Bassiri Gharb 10.1016/j.jhsa.2026.05.003 Journal of Hand Surgery (2026) 2026-06-05 Journal of Hand Surgery 2026-06-05 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00367-9/fulltext?rss=yes To evaluate whether a 30° passive metacarpophalangeal (MCP) joint hyperextension threshold was associated with postoperative mechanical and patient-reported outcomes when leaving MCP joint hyperextension unaddressed after performing trapeziectomy with suspensionplasty. Thumb Metacarpophalangeal Hyperextension in Patients Undergoing Basilar Thumb Joint Suspensionplasty: Are Preoperative Passive Measurements Predictive of Failure? Brandon Smetana, Drew Wrightson, Ryan Harold, Peter Henning, Gregory Merrell 10.1016/j.jhsa.2026.05.002 Journal of Hand Surgery (2026) 2026-06-05 Journal of Hand Surgery 2026-06-05 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00320-5/fulltext?rss=yes Wide-awake local anesthesia no tourniquet (WALANT) hand surgery produces less waste and carbon emissions than traditional operating room surgery. High procedural volumes and expanding adoption among hand surgeons’ position WALANT as a continued optimal target for waste-reduction initiatives. This study quantifies waste reduction after recycling implementation in a WALANT procedure room and identifies materials most contributory to total waste production. Recycling Implementation in Wide-Awake Local Anesthesia No Tourniquet Hand Surgery Miles C. Farlow, Bayli Price, Victoria Robinson, William G. Burks, Peter J. Apel, Cesar J. Bravo 10.1016/j.jhsa.2026.04.015 Journal of Hand Surgery 51, 8 (2026) 2026-06-01 Journal of Hand Surgery 2026-06-01 51 8 S0363-5023(26)X2006-8 Other Topics: Curated by Gregory Couzens 902.e1 902.e6 https://www.jhandsurg.org/article/S0363-5023(26)00362-X/fulltext?rss=yes Extrinsic ligament injury is necessary for scapholunate (SL) diastasis to occur in SL ligament injury. Prior studies demonstrate an association between dorsal extrinsic ligament injury and SL diastasis, but it is unclear what is the importance of volar extrinsic injury. This study aimed to characterize injury to the dorsal intercarpal ligament (DIC), dorsal radicarpal ligament (DRC), volar extrinsic ligaments (LRL/SRL/RSC), and scaphotrapezotrapezial (STT) ligaments to determine what extrinsic ligament injuries are independently associated with SL diastasis. Association of Extrinsic Ligament Injury with Diastasis in Scapholunate Ligament Injury Lente H.M. Dankelman, Kevin Kooi, Rene Balza Romeo, Jad S. Husseini, Ambrose J. Huang, Oscar Y. Shen, Neal C. Chen 10.1016/j.jhsa.2026.04.020 Journal of Hand Surgery 51, 8 (2026) 2026-05-27 Journal of Hand Surgery 2026-05-27 51 8 S0363-5023(26)X2006-8 Arthroscopy/Ligament: Curated by Sanjeev Kakar 855.e1 855.e7 https://www.jhandsurg.org/article/S0363-5023(26)00324-2/fulltext?rss=yes Carpal tunnel syndrome (CTS) causes enlargement of the median nerve cross-sectional area (CSA), which often decreases after carpal tunnel release. However, the clinical relevance of postoperative median nerve CSA changes remains unclear. This study aimed to assess the association between postoperative changes in median nerve CSA and clinical outcomes and to identify factors linked to a persistent or increased CSA. Postoperative Reduction and Persistent Enlargement of Median Nerve Cross-Sectional Area in Carpal Tunnel Syndrome: Influence of Metabolic Syndrome Yotaro Yamada, Tadahiro Natsume, Michiro Yamamoto 10.1016/j.jhsa.2026.04.019 Journal of Hand Surgery (2026) 2026-05-27 Journal of Hand Surgery 2026-05-27 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00318-7/fulltext?rss=yes Ulnar nerve injury causes weak pinch strength through paralysis of the first dorsal interosseus and adductor pollicis muscles. Current reconstructive strategies provide variable reanimation of these muscles. It has been suggested that nerve transfer of the opponens pollicis (OPB) motor branch to the terminal division of the deep branch of the ulnar nerve (TDDBUN) may successfully restore pinch strength. The true effectiveness of this intervention remains unknown as there are few cases in the literature with all originating from a single author. Restoration of Pinch Strength After Traumatic Ulnar Nerve Injury: Outcomes of Transfer of the Opponens Pollicis Branch to the Terminal Division of the Deep Branch of the Ulnar Nerve Madeline Rieker, Richard Arendale, Julia Mastracci, Ryan Serbin, Kayla Hietpas, Bryan Loeffler, Glenn Gaston 10.1016/j.jhsa.2026.04.013 Journal of Hand Surgery (2026) 2026-05-26 Journal of Hand Surgery 2026-05-26 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00314-X/fulltext?rss=yes Polyetheretherketone anchors used for thumb metacarpophalangeal (MP) joint ulnar collateral ligament (UCL) repair/reconstruction may be associated with osteolysis and subsequent failure, which presents challenges to revision reconstruction. This study evaluated the biomechanical integrity of thumb UCL reconstruction in a cadaveric osteolysis model. Biomechanical Strength of Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Reconstruction With Button Autograft and Suture Suspension (BASS) Technique in a Cadaveric Osteolysis Model Riley Kahan, Dylan R. Rakowski, Evan H. Richman, Adam Peszek, Todd Baldini, Matthew Belton, Alexander Lauder 10.1016/j.jhsa.2026.04.009 Journal of Hand Surgery (2026) 2026-05-26 Journal of Hand Surgery 2026-05-26 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00218-2/fulltext?rss=yes To compare the mid- to long-term outcomes of radial shortening osteotomy (RSO) and proximal row carpectomy (PRC) in treating Kienböck’s disease, using patient-reported outcomes, functional measures, and rates of secondary surgery. Save or Salvage: Radial Shortening Osteotomy and Proximal Row Carpectomy in Kienböck’s Disease—A Descriptive Study Tanis Quaife, Ian Diffey, Lukas Hashem, Wrist and Elbow Research Canada (WECAN) Affiliates, Ruby Grewal 10.1016/j.jhsa.2026.02.031 Journal of Hand Surgery (2026) 2026-05-26 Journal of Hand Surgery 2026-05-26 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00319-9/fulltext?rss=yes Various surgical options exist to treat thumb carpometacarpal (CMC) osteoarthritis, including trapeziectomy-based procedures and CMC denervation. Presently, there is limited data on the relative longevity of these 2 procedures, with conflicting data on the rates of secondary conversion after CMC denervation. We sought to investigate the rates of secondary surgery in patients undergoing trapeziectomy or denervation for CMC osteoarthritis. Thumb Carpometacarpal Joint Denervation Has Lower Reoperation Rates Than Trapeziectomy for Thumb Base Arthritis: A Retrospective Database Study Julian Wier, Daniel Rusu, Aidan Lindgren, Ali Azad, Luke T. Nicholson 10.1016/j.jhsa.2026.04.014 Journal of Hand Surgery 51, 8 (2026) 2026-05-25 Journal of Hand Surgery 2026-05-25 51 8 S0363-5023(26)X2006-8 Arthritis: Curated by Gustavo Gómez Rodríguez 847.e1 847.e8 https://www.jhandsurg.org/article/S0363-5023(26)00309-6/fulltext?rss=yes To determine the influence of evaluator experience, dynamic versus static ultrasound (US) image interpretation, and probe frequency on fascicle differentiation. The Influence of Evaluator Experience, Dynamic Versus Static Ultrasound Image Interpretation, and Probe Frequency on Fascicle Differentiation Luka Pušnik, Natalie Winter, Maks Matej Cuzak, Igor Serša, Nejc Umek, Žiga Snoj, Gregor Omejec 10.1016/j.jhsa.2026.04.004 Journal of Hand Surgery (2026) 2026-05-25 Journal of Hand Surgery 2026-05-25 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00308-4/fulltext?rss=yes To compare the short-term clinical outcomes and fracture rate of the silicone implants AVANTA and INTEGRA for metacarpophalangeal (MCP) joint arthroplasty in patients with rheumatoid arthritis (RA). A Comparative Study of Short-Term Outcomes Between INTEGRA and AVANTA Silicone Implants for Metacarpophalangeal Joints in Patients With Rheumatoid Arthritis Shuichi Naniwa, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Masahiro Horita, Toshifumi Ozaki 10.1016/j.jhsa.2026.04.003 Journal of Hand Surgery (2026) 2026-05-25 Journal of Hand Surgery 2026-05-25 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00317-5/fulltext?rss=yes To evaluate the clinical and radiological outcomes of a hybrid fixation technique combining intramedullary screw fixation with minimally invasive suture cerclage for the treatment of long-oblique and spiral metacarpal shaft fractures, patterns traditionally considered suboptimal for isolated intramedullary screw fixation. Minimally Invasive Hybrid Fixation for Unstable Metacarpal Shaft Fractures: A New Approach to Extend Intramedullary Screw Indications Sergi Barrera-Ochoa, Rita Pereira Cavaca, Andrés Alvial-San Martín, Pilar Saralegui, Beatriz Miron-Dominguez, Melissa Bonilla-Chaperon 10.1016/j.jhsa.2026.04.012 Journal of Hand Surgery (2026) 2026-05-23 Journal of Hand Surgery 2026-05-23 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00316-3/fulltext?rss=yes In many nerve injuries, tissue destruction, scar, and other factors prohibit surgical reapproximation of the nerve ends without excessive tension. The resultant nerve gap has traditionally been bridged using autologous sensory nerve; however, the harvest of autologous nerve graft adds time and donor site morbidity. Over the past decades, a variety of commercially available hollow conduits designed for nerve gap reconstruction have been used. More recently, commercially available processed human nerve allograft has been introduced with the promise of reconstruction whose success rivals the results of nerve autograft. Nerve Gap Reconstruction Casey Imbergamo, Ellie Moeller, Sierra Lindsey, Aviram M. Giladi, Joel S. Solomon 10.1016/j.jhsa.2026.04.011 Journal of Hand Surgery 51, 8 (2026) 2026-05-23 Journal of Hand Surgery 2026-05-23 51 8 S0363-5023(26)X2006-8 Current Concepts 920 926 https://www.jhandsurg.org/article/S0363-5023(26)00310-2/fulltext?rss=yes Unlike pediatric trigger thumb, which is cured by A1 pulley release, pediatric trigger fingers (PTFs) have a high rate of recurrence with A1 pulley release alone. The flexor digitorum superficialis (FDS) splitting technique has the potential to mitigate recurrence without the need for more extensive dissection. This study investigates the clinical outcomes of A1 pulley release with concomitant A2 pulley partial release and FDS splitting in the treatment of PTF. Resolution of Pediatric Trigger Finger After Combined A1 Pulley Release, A2 Pulley Partial Release, and Flexor Digitorum Superficialis Tendon Split Timothy W. Kouo, Dan Gordon, Aaron Perkins, David Farbo, Pamela J. Sherman 10.1016/j.jhsa.2026.04.005 Journal of Hand Surgery 51, 8 (2026) 2026-05-23 Journal of Hand Surgery 2026-05-23 51 8 S0363-5023(26)X2006-8 Pediatric Hand and Upper Extremity: Curated by Michelle James 877 881 https://www.jhandsurg.org/article/S0363-5023(26)00315-1/fulltext?rss=yes Pediatric hand surgery frequently requires precise surgical reconstruction of the upper limb to prevent worsening deformity. However, there is a balance of achieving a perfect radiologic film of the planned surgery and causing inadvertent harm from performing overly aggressive surgery. Precise K-wire placement and immobilization are important for optimal results; however, surgery that is too invasive results in several downsides, including loss of reduction, poor bony healing, loss of blood supply, growth plate failure, and scar contractures from poor wound healing. Good Enough: When to Avoid Perfection and Accept Adequate Surgery Results in Pediatric Hand Surgery Alex J. Davit, Kelsi N. Krakauer, Aaron J. Berger, Michael G. Galvez 10.1016/j.jhsa.2026.04.010 Journal of Hand Surgery (2026) 2026-05-21 Journal of Hand Surgery 2026-05-21 The Hand Surgery Landscape https://www.jhandsurg.org/article/S0363-5023(26)00251-0/fulltext?rss=yes The purpose of this study was to compare wrist range of motion (ROM) and tendon forces before and after implantation of a recently designed total wrist arthroplasty (TWA). Our hypothesis was that following TWA, the ROM would decrease and the tendon forces increase. In Vitro Kinetic and Kinematic Analysis of a Recently Designed Total Wrist Implant Salvatore M. Cavallaro, Brian J. Harley, Frederick W. Werner 10.1016/j.jhsa.2026.03.015 Journal of Hand Surgery 51, 8 (2026) 2026-05-18 Journal of Hand Surgery 2026-05-18 51 8 S0363-5023(26)X2006-8 Arthritis: Curated by Gustavo Gómez Rodríguez 846.e1 846.e7 https://www.jhandsurg.org/article/S0363-5023(26)00250-9/fulltext?rss=yes Considerable variation exists in strategies for the diagnosis and treatment of neurogenic thoracic outlet syndrome (NTOS). Additionally, different subtypes of NTOS present with different constellations of symptoms and signs. The aim of this study was to gather and evaluate different treatment plans from high-volume NTOS surgeons for standardized case scenarios. Strategies for Work-up and Treatment of Case Scenarios in Neurogenic Thoracic Outlet Syndrome Harvey Chim, INTOS Workgroup 10.1016/j.jhsa.2026.03.014 Journal of Hand Surgery (2026) 2026-05-18 Journal of Hand Surgery 2026-05-18 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00252-2/fulltext?rss=yes Thumb carpometacarpal (CMC) joint arthritis often presents with metacarpophalangeal (MCP) joint hyperextension. Although CMC joint arthrodesis and trapeziectomy are established treatments, their effects on MCP joint hyperextension and functional outcomes stratified by MCP joint status remain unclear. We assessed correction of MCP joint hyperextension and functional improvement according to preoperative MCP joint status after CMC joint arthrodesis or trapeziectomy and compared outcomes between procedures in patients with preoperative MCP joint hyperextension. Arthrodesis Versus Trapeziectomy for Thumb Carpometacarpal Joint Arthritis with Metacarpophalangeal Joint Hyperextension Tomoki Matsuo, Masao Nishiwaki, Masato Okazaki, Yasuhiro Kiyota, Taku Suzuki, Takuji Iwamoto, Kenichi Tazaki 10.1016/j.jhsa.2026.03.016 Journal of Hand Surgery (2026) 2026-05-15 Journal of Hand Surgery 2026-05-15 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00245-5/fulltext?rss=yes Hand surgeons face unique ergonomic challenges because of prolonged seated positions, precise motor demands, postural strain from magnification equipment, and repetitive micromovements. Ergonomic interventions specific to hand surgery remain grossly understudied. This nonsystematic review addresses the musculoskeletal burden in hand surgery and provides evidence-based ergonomic recommendations. For microsurgery, maintaining neutral head positioning with properly aligned microscopes and incorporating microbreaks reduced strain. Sustainable Surgery: A Hand Surgeon’s Guide to Ergonomics Tobi J. Somorin, Sripadh B. Sharma, April Chambers, Mark S. Redfern, Nicole J. Jarrett 10.1016/j.jhsa.2026.03.009 Journal of Hand Surgery (2026) 2026-05-15 Journal of Hand Surgery 2026-05-15 Current Concepts https://www.jhandsurg.org/article/S0363-5023(25)00715-4/fulltext?rss=yes We investigated the complication profile and effectiveness of arthrodesis, trapeziectomy without suspensionplasty or ligament reconstruction (S/LR), trapeziectomy with S/LR, and joint replacement (JR) for the management of base-of-thumb arthritis. We included cases of interposition material placement within the trapeziectomy without the S/LR group. Clinical Outcomes of Surgical Options for Base-of-Thumb Arthritis: A Systematic Review and Network Meta-Analysis Nikki Burnett, Tim Cheok, Kenneth Wills, Zachary Van Hout, Yun Xiang Zhang, Max McCarthy, Thomas Smith, Ruurd Jaarsma, Narlaka Jayasekera 10.1016/j.jhsa.2025.12.011 Journal of Hand Surgery 51, 8 (2026) 2026-05-15 Journal of Hand Surgery 2026-05-15 51 8 S0363-5023(26)X2006-8 Arthritis: Curated by Gustavo Gómez Rodríguez 835 845 https://www.jhandsurg.org/article/S0363-5023(25)00512-X/fulltext?rss=yes Although carpal tunnel release (CTR) is a common procedure for carpal tunnel syndrome (CTS), few studies define the postoperative recovery timeline for CTR. Therefore, we aimed to investigate the timing to achieve a clinically meaningful improvement and the timing for reaching a plateau in improvement in patient-reported outcome measurements (PROMs) after CTR for CTS. Second, we compared the improvement trend in PROMs with that of nerve conduction studies. Longitudinal Changes in Patient-Reported Outcomes Following Carpal Tunnel Release: A Retrospective Cohort Study Kosuke Saito, Mitsuhiro Okada, Shunpei Hama, Yusuke Miyashima, Hidetomi Terai 10.1016/j.jhsa.2025.09.011 Journal of Hand Surgery 51, 8 (2026) 2026-05-08 Journal of Hand Surgery 2026-05-08 51 8 S0363-5023(26)X2006-8 Nerve: Curated by Harvey W. Chim 867 874 https://www.jhandsurg.org/article/S0363-5023(26)00249-2/fulltext?rss=yes The majority of brachial plexus birth injuries (BPBI) occur without prenatally identifiable risk factors. This meta-analysis mapped BPBI incidence worldwide as a preliminary step toward investigating population-level predictors. Mapping Population-Level Differences in Brachial Plexus Birth Injury: An International Meta-Analysis Holly Cordray, Miguel Fiandeiro, Seungjun Lee, Roger Cornwall, Petra Grahn, Marja Kaijomaa, M. Claire Manske, Melissa Previtera, Apurva S. Shah 10.1016/j.jhsa.2026.03.013 Journal of Hand Surgery (2026) 2026-05-07 Journal of Hand Surgery 2026-05-07 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00246-7/fulltext?rss=yes The wide-awake local anesthesia no tourniquet (WALANT) approach has been proposed as a promising alternative to general anesthesia (GA) for hand surgery. However, evidence in the pediatric population remains limited. The objective of this study was to evaluate its impact on clinical outcomes, procedural efficiency, and institutional costs for pediatric trigger thumb (PTT) release. Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus General Anesthesia for Pediatric Trigger Thumb Release: Clinical Outcomes, Efficiency, and Costs Aidan Shulkin, Xiya Ma, Daniel Borsuk, Charlotte Jaloux, Emilie Bougie 10.1016/j.jhsa.2026.03.010 Journal of Hand Surgery (2026) 2026-05-07 Journal of Hand Surgery 2026-05-07 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00243-1/fulltext?rss=yes Peripheral nerve injuries have profound consequences for physical, psychological, and social functioning. Advances have improved outcomes; however, patients frequently experience residual symptoms and incomplete recovery. Traditional measures of success emphasize clinician-defined benchmarks, which may not fully capture the lived experience of recovery. This study explores how patients define “success” after nerve reconstruction, how these definitions align or diverge from those used by clinicians, and the contextual factors that shape patient perceptions of recovery. Measuring What Matters: Patient Perspectives on Success and Recovery After Nerve Injury Bryce F. Rizvanović, Julia A.V. Nuelle, Daniel A. London, Lisa A. Royse 10.1016/j.jhsa.2026.03.007 Journal of Hand Surgery 51, 8 (2026) 2026-04-27 Journal of Hand Surgery 2026-04-27 51 8 S0363-5023(26)X2006-8 Nerve: Curated by Harvey W. Chim 876.e1 876.e11 https://www.jhandsurg.org/article/S0363-5023(26)00242-X/fulltext?rss=yes The motor branch to the brachialis muscle has been described as a versatile donor in upper limb nerve reconstruction. This includes patients with peripheral nerve injuries and tetraplegia. However the anatomic feasibility of transfers from the musculocutaneous nerve to radial nerve branches around the elbow has not been systematically evaluated. This study aims to assess this feasibility. Such a transfer may be particularly relevant in patients with high-level tetraplegia or in patients with spastic upper limb involvement, in which selective denervation of spastic elbow flexors could be combined with nerve transfer to paretic wrist and/or finger extensors. Brachialis Branch to Radial Nerve Transfer for Reanimation of Wrist and Finger Extension: An Anatomical Feasibility Study De Lepeleere Bram, Plasschaert Frank, Cornette Bram, Cordier Fleur, Fitoussi Franck 10.1016/j.jhsa.2026.03.006 Journal of Hand Surgery 51, 8 (2026) 2026-04-25 Journal of Hand Surgery 2026-04-25 51 8 S0363-5023(26)X2006-8 Nerve: Curated by Harvey W. Chim 875.e1 875.e10 https://www.jhandsurg.org/article/S0363-5023(26)00212-1/fulltext?rss=yes The main postoperative complications after fixation of ulna shaft fractures are nonunion and soft tissue irritation. Current standards recommend 3.5 mm locking compression plates, which are prone to cause soft tissue irritation, necessitating secondary implant removal in approximately 25% of cases. Therefore, an alternative approach considering a combination of two minifragment locking plates has been proposed. The aim of this study was to biomechanically compare a single 3.5 mm locking compression plate fixation versus dual minifragment locked plating of ulna shaft fractures in a human cadaveric model. Biomechanical Analysis of Standard Locking Compression Plate versus Dual Minifragment Locking Plates in Ulna Shaft Fracture Fixation: A Human Cadaveric Study Moritz Kraus, Luke van Rossenberg, Ivan Zderic, Tatjana Pastor, Boyko Gueorguiev, R. Geoff Richards, Tabea Katharina Breckwoldt, Hans-Christoph Pape, Frank J.P. Beeres, Torsten Pastor 10.1016/j.jhsa.2026.02.025 Journal of Hand Surgery (2026) 2026-04-24 Journal of Hand Surgery 2026-04-24 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00241-8/fulltext?rss=yes The purpose of this study was to compare the clinical and radiographic outcomes 5 years after randomization to volar plating or combined plating for surgical treatment of an AO (Arbeitsgemeinschaft für Osteosynthesefragen) type C distal radius fracture (DRF). Volar Plating Versus Combined Plating For AO Type C Distal Radius Fracture: A Randomized Controlled Study Of 135 Patients With A 5-Year Follow-Up Ásgerdur Thórdardóttir, Marcus Sagerfors, Jonny Andersson, Hana Gavlovská, Eva Lundqvist 10.1016/j.jhsa.2026.03.005 Journal of Hand Surgery (2026) 2026-04-21 Journal of Hand Surgery 2026-04-21 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00244-3/fulltext?rss=yes Thumb phalangeal and metacarpal fractures are undergoing surgical intervention more frequently and can be stabilized using a range of modalities. Intramedullary screw (IMS) fixation has become more common in the management of these fractures. Violation of the articular cartilage and the extensor tendon is a concern when IMS fixation is used. The aim of this study was to assess the cartilaginous and soft tissue footprint resulting from retrograde IMS insertion in the proximal phalanx and metacarpal of the thumb. Soft Tissue Violation Following Intramedullary Screw Fixation of Fractures in the Thumb: A Cadaveric Study Samuel Gray, Michael Strong, Elizabeth Clarke, David Graham, Brahman Sivakumar 10.1016/j.jhsa.2026.03.008 Journal of Hand Surgery (2026) 2026-04-20 Journal of Hand Surgery 2026-04-20 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00227-3/fulltext?rss=yes Carpal tunnel syndrome is the most common upper-extremity compressive neuropathy, resulting from increased pressure within the carpal tunnel leading to symptomatic median nerve dysfunction. While conservative measures may offer temporary relief, surgical decompression remains the definitive treatment for persistent or progressive disease. Multiple surgical techniques for carpal tunnel release (CTR) have been described, each with distinct advantages and limitations. This review provides an updated synthesis of the evidence surrounding CTR, beginning with an overview of the conventional open and the mini-open approaches. Carpal Tunnel Release Surgical Techniques Rayan El Bachaoui, Brandon E. Earp, Philip E. Blazar, Dafang Zhang 10.1016/j.jhsa.2026.03.004 Journal of Hand Surgery 51, 8 (2026) 2026-04-16 Journal of Hand Surgery 2026-04-16 51 8 S0363-5023(26)X2006-8 Current Concepts 914 919 https://www.jhandsurg.org/article/S0363-5023(26)00213-3/fulltext?rss=yes The application of arthroscopy in the proximal interphalangeal joints can avoid scar development and joint contracture. However, conventional arthroscopic techniques are difficult to apply to the palmar side of the joint. This study aimed to explore the feasibility and safety of the inside-out volar portal arthroscopic technique for the proximal interphalangeal joint, elucidating a new portal technique for the inspection and treatment of small joints. Inside-out Volar Portal of Arthroscopy of Proximal Interphalangeal Joints: A Cadaver Study Yuwei Liu, You Xie, Yangyang Hong, Jianquan Liu, Wencui Li, Zhe Zhao 10.1016/j.jhsa.2026.02.026 Journal of Hand Surgery (2026) 2026-04-16 Journal of Hand Surgery 2026-04-16 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00172-3/fulltext?rss=yes Upper-extremity spasticity is a functionally limiting symptom of upper motor neuron syndrome that can lead to musculotendinous and joint contractures. Surgical interventions, including hyperselective and selective neurectomies, have shown sustained efficacy in treating the spastic upper limb and have recently gained notable traction. We hypothesized that, in the long-term, surgical procedures are a cost-effective option for management of upper-extremity spasticity compared with neurotoxin therapy. Comparative Cost Analysis of Surgery Versus Neurotoxin Injection for Long-Term Management of Upper-Extremity Spasticity Benjamin Savitz, Orlane Caro, Mariam Saad, Daniel O’Neill, Shady Elmaraghi 10.1016/j.jhsa.2026.02.023 Journal of Hand Surgery 51, 8 (2026) 2026-04-16 Journal of Hand Surgery 2026-04-16 51 8 S0363-5023(26)X2006-8 Pediatric Hand and Upper Extremity: Curated by Michelle James 882.e1 882.e8 https://www.jhandsurg.org/article/S0363-5023(26)00224-8/fulltext?rss=yes This study aimed to evaluate the prognostic importance of radial translation on functional outcomes in patients treated nonoperatively or surgically for distal radial fractures. It was hypothesized that increased radial translation would be associated with worse functional scores, regardless of treatment modality. Evaluation of the Relationship Between Radial Translation and Functional Outcomes in Nonsurgical and Surgically Treated Distal Radius Fractures Yusuf Yahşi, Yusuf Sülek, Süleyman Çakırtürk, Rodi Ertoğrul, Hacı Mustafa Özdemir 10.1016/j.jhsa.2026.02.037 Journal of Hand Surgery (2026) 2026-04-15 Journal of Hand Surgery 2026-04-15 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00223-6/fulltext?rss=yes The aim of this study was to evaluate the interobserver reliability of 3 commonly used arthroscopic diagnostic signs for assessing triangular fibrocartilage complex (TFCC) lesions: the trampoline test, the hook test, and the suction test. Interobserver Reliability of the Trampoline Test, Hook Test, and Suction Test in Arthroscopic Assessment of Triangular Fibrocartilage Complex Lesions Hideo Hasegawa, Michel Levadoux, Alexandre Quemener-Tanguy, Lucas Audiffret, Jean-Baptiste De Villeneuve Bargemon 10.1016/j.jhsa.2026.02.036 Journal of Hand Surgery 51, 8 (2026) 2026-04-15 Journal of Hand Surgery 2026-04-15 51 8 S0363-5023(26)X2006-8 Arthroscopy/Ligament: Curated by Sanjeev Kakar 848 853 https://www.jhandsurg.org/article/S0363-5023(26)00216-9/fulltext?rss=yes Fingertip amputations present a reconstructive challenge because of the varying degrees of tissue loss, bony exposure, and functional impact. Often, providers must decide between occlusive dressings and local flap reconstruction. This systematic review aims to analyze outcomes of both treatment modalities to determine the benefits and risks of each. Choosing Local Flaps Versus Occlusive Dressings in Fingertip Amputations: A Systematic Review and Meta-Analysis With Proposed Algorithm Kasra Rahmati, Nirbhay S. Jain, Rashed Alananzeh, Lauren E. Wessel 10.1016/j.jhsa.2026.02.029 Journal of Hand Surgery (2026) 2026-04-08 Journal of Hand Surgery 2026-04-08 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00219-4/fulltext?rss=yes The dynamic evaluation of ulnar impaction syndrome has recently garnered interest; however, its underlying mechanism remains unclear. This research aimed to analyze the dynamic ulnar impaction biomechanically during axial loading. Influence of Dynamic Factors on Ulnar Impaction Syndrome: An Axial Compression Test Using Fresh-Frozen Cadavers Kinshiro Nabeshima, Yusuke Matsuura, Takahiro Yamazaki, Aya Kanazuka, Seiji Ohtori, Takane Suzuki 10.1016/j.jhsa.2026.02.032 Journal of Hand Surgery (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00140-1/fulltext?rss=yes Although hand transplantation in the adult population is increasingly recognized as an acceptable reconstructive treatment, the ethical trade-offs of performing hand transplants in the pediatric population require closer scrutiny. This analysis applies the concepts of the best interest standard, the Harm Principle, and protections for vulnerable populations to weigh the risks and benefits of immunocompetent pediatric hand transplantation. As only two pediatric hand transplants have been performed to date, much of the outcome data has been extrapolated from the adult population. Current Ethics of Hand Transplants in Non-Immunocompromised Children Jaclyn T. Mauch, Leah M. Gudex, Casey J. Humbyrd, Ines C. Lin, Christian J. Vercler 10.1016/j.jhsa.2026.02.008 Journal of Hand Surgery (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00211-X/fulltext?rss=yes Sign language is a predominant form of nonverbal communication in the United States with 7 million signers nationally, one million of which are deaf or hard-of-hearing. This population is particularly vulnerable to impaired communication when confronting upper-extremity impairment resulting from extensive long-term use in their communication. Given the high importance of adequate upper-extremity mobility for sign language users, hand surgeons must carefully choose the appropriate treatment modalities to minimize disruptions in this population’s ability to communicate in their daily lives. Talk Through the Hand: Upper-Extremity Injury and Surgical Considerations in Sign Language Users Sarah A. Uriarte, Jason Nguyen, Ali Mansour, Elijah M. Persad, Vinay Rao, Reena A. Bhatt 10.1016/j.jhsa.2026.02.024 Journal of Hand Surgery (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 The Hand Surgery Landscape https://www.jhandsurg.org/article/S0363-5023(26)00168-1/fulltext?rss=yes To characterize delayed “hidden” nail regrowth after homodigital dorsal adipofascial reverse flap reconstruction of distal fingertips and to evaluate the outcomes of a standardized, matrix-sparing secondary exposure technique. Exposing the Hidden Nail: Matrix-Sparing Secondary Exposure After Adipofascial Flap Reconstruction of Distal Fingertips Fabiana Battaglia, Michele Rosario Colonna, Luigi Troisi, Gabriele Delia 10.1016/j.jhsa.2026.02.020 Journal of Hand Surgery 51, 8 (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 51 8 S0363-5023(26)X2006-8 Other Topics: Curated by Gregory Couzens 894 901 https://www.jhandsurg.org/article/S0363-5023(26)00138-3/fulltext?rss=yes This purpose of this study was to evaluate the patient-reported outcomes of surgically and nonsurgically treated complete and partial distal biceps tears (DBTs) and report the conversion-to-surgery rate for patients initially treated nonsurgically. Thirty-Six Percent Conversion to Surgery Rate for Nonsurgical Treatment of Complete and Partial Distal Biceps Tears Matthew J. Schultz, Samantha Riebesell, Stephanie Kwan, Tyler Radack, Michael Rivlin, Jacob Tulipan 10.1016/j.jhsa.2025.12.027 Journal of Hand Surgery 51, 8 (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 51 8 S0363-5023(26)X2006-8 Tendon: Curated by Armin Kraus 893.e1 893.e8 https://www.jhandsurg.org/article/S0363-5023(26)00214-5/fulltext?rss=yes Survivors of focal neurological injuries experience accelerated bone loss, particularly in the paretic upper extremity, substantially increasing the risk of fragility fractures. Mechanical unloading, neuromuscular impairment, and altered bone remodeling contribute to rapid reductions in bone mineral density and unfavorable changes in bone geometry within the first year after stroke and brachial plexus palsy. Despite growing evidence, bone health assessment is rarely incorporated into routine poststroke care, and referrals often occur only after fracture. Fragility Fractures in Focal Neurological Conditions Aslan Baradaran, Tamara D. Rozental 10.1016/j.jhsa.2026.02.027 Journal of Hand Surgery (2026) 2026-04-01 Journal of Hand Surgery 2026-04-01 The Hand Surgery Landscape https://www.jhandsurg.org/article/S0363-5023(26)00165-6/fulltext?rss=yes Prospective clinical registries that apply standardized diagnostic criteria and established outcome measures have been developed globally to better understand congenital upper limb differences. This study explores the perspectives of surgeons who have been instrumental in forming and maintaining Congenital Upper Limb Difference registries in the United States (Congenital Upper Limb Difference), Northern Europe (Congenital Upper Limb Anomalies North), Australia (Australia Hand Difference Registry), and the United Kingdom (UK Hand Registry). Establishing and Maintaining Congenital Upper Limb Difference Registries: Insights From Global Experiences Adam Mosa, Sarah Romans, Charles A. Goldfarb, Lindley B. Wall 10.1016/j.jhsa.2026.02.017 Journal of Hand Surgery 51, 8 (2026) 2026-04-01 Journal of Hand Surgery 2026-04-01 51 8 S0363-5023(26)X2006-8 Pediatric Hand and Upper Extremity: Curated by Michelle James 883.e1 883.e8 https://www.jhandsurg.org/article/S0363-5023(26)00148-6/fulltext?rss=yes Because of the biological, anatomical, and biomechanical characteristics of the scaphoid, treating some proximal pole nonunions remains challenging. The location of the nonunion (proximal or distal to the dorsal apex) may influence its natural history. Based on this concept, patients with a proximal pole nonunion located proximal to the dorsal apex and maintaining an intact insertion of the dorsal scapholunate ligament in the distal fragment of the scaphoid may benefit from simple excision of the proximal pole. Simple Excision of Proximal Scaphoid Nonunion: A Viable Option When the Scapholunate Ligament Is Intact Ana Scott-Tennent De Rivas, Pau Forcada Calvet, Mireia Esplugas Mimó, Ignacio Esteban Feliu, Guillem Salvà Coll, Álex Lluch Bergadà 10.1016/j.jhsa.2026.01.032 Journal of Hand Surgery 51, 8 (2026) 2026-04-01 Journal of Hand Surgery 2026-04-01 51 8 S0363-5023(26)X2006-8 Arthroscopy/Ligament: Curated by Sanjeev Kakar 854.e1 854.e10 https://www.jhandsurg.org/article/S0363-5023(26)00122-X/fulltext?rss=yes The radial head and neck feature a unique anatomical structure, whereby the application of a plate in certain areas can lead to impingement, subsequently restricting the forearm rotation. Various techniques have been suggested to identify the appropriate region for plate fixation. We propose an alternative method to locate a safe zone for plate placement and conduct a comparative analysis with previously established methods. A Simplified Method for Determining the Safe Zone in Proximal Radial Plate Fixation Piyabuth Kittithamvongs, Prapasiri Chareonsri, Sopinun Siripoonyothai, Navapong Anantavorasakul, Kanchai Malungpaishrope, Chairoj Uerpairojkit 10.1016/j.jhsa.2026.02.003 Journal of Hand Surgery (2026) 2026-03-21 Journal of Hand Surgery 2026-03-21 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00120-6/fulltext?rss=yes Fractures of the thumb encompass a diverse spectrum of injury patterns, each requiring nuanced consideration of various treatment strategies. Associated conditions include injuries to the ulnar collateral ligament and radial collateral ligament of the metacarpophalangeal joint, which can significantly impact thumb stability and function. Although extra-articular fractures of the thumb metacarpal and phalanges are more tolerant of residual deformity due to compensatory movement of the carpometacarpal joint, intra-articular fractures, including Bennett and Rolando fractures, often benefit from surgical intervention to restore articular congruity. Thumb Fractures and Associated Injuries: An Evidence Based Review to Guide Treatment Brian W. Yang, Robin N. Kamal, Lauren M. Shapiro 10.1016/j.jhsa.2026.02.001 Journal of Hand Surgery (2026) 2026-03-20 Journal of Hand Surgery 2026-03-20 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00125-5/fulltext?rss=yes Ring avulsion injuries, though rare, represent a uniquely devastating subset of hand trauma, with circumferential damage to skin, tendon, bone, and neurovascular structures. Historically, these injuries were almost universally treated with amputation; however, advances in microsurgical repair have transformed management and opened the possibility of finger salvage. We review the epidemiology, classification systems, treatment options, and biomechanical studies that have prompted innovations in ring manufacturing. Current Concepts in Ring Avulsion Injuries Lacey Smith, Igor Immerman, Nicole Schroeder, Lauren M. Shapiro 10.1016/j.jhsa.2026.01.020 Journal of Hand Surgery (2026) 2026-03-19 Journal of Hand Surgery 2026-03-19 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00050-X/fulltext?rss=yes Thumb carpometacarpal joint arthrosis is the second most common form of degenerative joint disease in the hand but the most frequent form of arthrosis treated surgically. Traditional surgical management involving trapeziectomy dates to the 1940s, with several modifications having evolved to improve stability, strength, appearance, and convalescence. However, although most outcomes of resection arthroplasty are good, they fail to completely restore the joint to its previous vitality, and strong clinical evidence of superiority of any technique is lacking. Total Joint Arthroplasty for the Thumb Carpometacarpal Joint Rick Tosti, Joris Duerinckx 10.1016/j.jhsa.2026.01.003 Journal of Hand Surgery (2026) 2026-03-04 Journal of Hand Surgery 2026-03-04 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00054-7/fulltext?rss=yes Kirschner wire (K-wire) infections continue to be a challenge in hand surgery. Our purpose was to quantify the frequency of K-wire site infections of the hand and wrist, to tabulate major and minor infectious manifestations, to identify factors that may predispose a patient to major complications, and to generate an updated algorithm for prognostication and treatment of K-wire site infections. Kirschner Wire Skeletal Fixation in the Hand and Wrist: Risk of Infection and Predictors of Progression to Major Complications Mitchell S. Mologne, Julia M. Perugini, Nicholas A. Calotta, Lindley B. Wall, Charles A. Goldfarb 10.1016/j.jhsa.2026.01.005 Journal of Hand Surgery 51, 8 (2026) 2026-03-02 Journal of Hand Surgery 2026-03-02 51 8 S0363-5023(26)X2006-8 Fracture/Trauma: Curated by Stephen Tham 856 863 https://www.jhandsurg.org/article/S0363-5023(26)00123-1/fulltext?rss=yes This study compared cadaveric distal ulnar neck fractures following fixation with either retrograde intramedullary threaded nail (IMTN) fixation or volar-locked plate and screw (VLPS) fixation. We hypothesized that there would be no differences in fatigue resistance between the two methods. Stability of Distal Ulnar Neck Fractures During Cyclic Loading Following Intramedullary Threaded Nail Fixation or Volar-Locking Plate and Screw Fixation: A Cadaveric Biomechanical Comparison Alexander D. Jeffs, Andrew D. Allen, Rahul Radhakrishna, Stephen M. Himmelberg, Zohair S. Zaidi, Gregory M. Knoll, J. Megan Patterson, Jacqueline H. Cole, Reid W. Draeger 10.1016/j.jhsa.2026.01.018 Journal of Hand Surgery (2026) 2026-02-28 Journal of Hand Surgery 2026-02-28 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00055-9/fulltext?rss=yes Intramedullary screws in single- or double-screw configurations are increasingly used for proximal phalanx (P1) fractures. Our purpose was to assess the biomechanical rotational stability of antegrade one- versus two-screw constructs in the fixation of simulated transverse mid-diaphyseal P1 fractures. Rotational Stability of One Versus Two Intramedullary Screws for Proximal Phalanx Fractures: A Biomechanical Study Rae Tarapore, Andrew O’Brien, Zakkary Walterscheid, Manaswini Chennoju, Pooyan Abbasi, Kenneth R. Means, Aviram M. Giladi 10.1016/j.jhsa.2026.01.011 Journal of Hand Surgery (2026) 2026-02-16 Journal of Hand Surgery 2026-02-16 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00059-6/fulltext?rss=yes Madelung deformity is a rare congenital wrist deformity characterized by growth disturbance of the volar–ulnar aspect of the distal radial physis, leading to progressive wrist deformity, pain, and stiffness. Madelung deformity is frequently associated with genetic conditions such as Leri–Weill dyschondrosteosis and Turner syndrome, and more recently, mutations in the GNAS gene have been implicated. Diagnosis is based on clinical findings and radiographic criteria, with plain radiographs demonstrating characteristic volar–ulnar radial curvature, positive ulnar variance, and carpal subluxation. Madelung Deformity: A Current Concepts Review Eric R. Taleghani, Mason Price, Iris Gutmark-Little, Kevin J. Little 10.1016/j.jhsa.2026.01.009 Journal of Hand Surgery 51, 8 (2026) 2026-02-13 Journal of Hand Surgery 2026-02-13 51 8 S0363-5023(26)X2006-8 Current Concepts 903 913 https://www.jhandsurg.org/article/S0363-5023(25)00721-X/fulltext?rss=yes Hand trauma is a challenge to triage and manage, especially in rural states, because of the relative paucity of fellowship-trained hand surgeons and equipped treatment centers. Since the establishment of the Arkansas Hand Trauma Telemedicine Program (AHTTP) in 2014, early data suggest a successful reduction in hospital transfers for hand trauma. The purpose of this economic and decision analysis study was to perform a comprehensive, longer-term analysis describing trends in emergency medical service (EMS) transfer rate for hand trauma in Arkansas in relation to the establishment of AHTTP. Ten Years of a Novel Telemedicine System for Management of Statewide Hand Trauma Decreases EMS Transfer Rate and Health Care Costs in Arkansas Katherine Montoya, Amy Schexnayder, Austin Porter, Theresa Wyrick 10.1016/j.jhsa.2025.12.015 Journal of Hand Surgery (2026) 2026-02-07 Journal of Hand Surgery 2026-02-07 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(25)00723-3/fulltext?rss=yes To the best of our knowledge, no prior biomechanical study has determined how much fracture obliquity can be tolerated with intramedullary screw fixation. The purpose of this study was to compare the stiffness, load to failure, and fracture gapping of intramedullary fixation for oblique metacarpal fractures. Intramedullary Fixation for Short and Long Oblique Metacarpal Fractures: A Biomechanical Analysis Dang-Huy Do, Angel Valencia, Scott Oishi, Douglas Sammer, Daniel Koehler 10.1016/j.jhsa.2025.12.017 Journal of Hand Surgery (2026) 2026-01-28 Journal of Hand Surgery 2026-01-28 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00720-8/fulltext?rss=yes Internal fixation with a headless compression screw has become the gold standard for the surgical treatment of scaphoid fractures. Some authors reported on the theoretical benefit of dual screw fixation. Our aim was to investigate the optimal dual screw configuration for fixing scaphoid fractures with regard to biomechanical stability. Finite Element Analysis of Dual Screw Configurations for Enhanced Stability in Scaphoid Fracture Fixation Esin Rothenfluh, Sambhav Jain, William R. Taylor, Seyyed Hamed Hosseini Nasab 10.1016/j.jhsa.2025.12.014 Journal of Hand Surgery (2026) 2026-01-28 Journal of Hand Surgery 2026-01-28 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00709-9/fulltext?rss=yes The aim of our study was to perform a cost-utility analysis comparing trapeziometacarpal joint (TMJ) implant arthroplasty with resection-suspension-interposition arthroplasty (RSIA) during 1 year after surgery. Cost-Effectiveness of Trapeziometacarpal Dual Mobility Implant Arthroplasty Compared to Resection Arthroplasty Miriam Marks, Kei Mathis, Stephan Schindele, Daniel B. Herren 10.1016/j.jhsa.2025.12.005 Journal of Hand Surgery (2026) 2026-01-28 Journal of Hand Surgery 2026-01-28 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(25)00660-4/fulltext?rss=yes The purpose of this study was to compare the clinical outcomes, radiographs, and complications of radial head arthroplasty in patients with concomitant Monteggia or transolecranon fracture dislocations to patients with isolated radial head fractures. The Effect of an Associated Monteggia or Transolecranon Fracture Dislocation on Outcomes of Radial Head Arthroplasty Jimmy Tat, Chloe Cadieux, Ruby Grewal, George S. Athwal, Kenneth J. Faber, Darren S. Drosdowech, Graham J.W. King 10.1016/j.jhsa.2025.11.014 Journal of Hand Surgery 51, 8 (2026) 2026-01-14 Journal of Hand Surgery 2026-01-14 51 8 S0363-5023(26)X2006-8 Fracture/Trauma: Curated by Stephen Tham 866.e1 866.e13 https://www.jhandsurg.org/article/S0363-5023(25)00658-6/fulltext?rss=yes First dorsal compartment tendonitis is a common cause of radial wrist pain. Initial treatments include corticosteroid injections, bracing, and anti-inflammatory medications, with surgical release reserved for persistent symptoms. This study investigated the efficacy of injections and intervention-free survival time. Intervention-Free Survival Analysis Following Corticosteroid Injection in First Dorsal Compartment Tendonitis Joshua K. Kim, Suhail K. Mithani, Warren C. Hammert 10.1016/j.jhsa.2025.11.013 Journal of Hand Surgery 51, 8 (2026) 2026-01-07 Journal of Hand Surgery 2026-01-07 51 8 S0363-5023(26)X2006-8 Tendon: Curated by Armin Kraus 884 892 https://www.jhandsurg.org/article/S0363-5023(25)00607-0/fulltext?rss=yes Bennett fractures are inherently unstable intra-articular fractures of the first metacarpal base and are subject to multiple deforming forces. Suboptimal treatment can lead to fracture displacement, malunion, and post-traumatic arthritis of the carpometacarpal joint. The purpose of this study was to evaluate three fixation techniques for the stabilization of Bennett fractures. Our hypothesis was that screw fixation would be stiffer than the other methods. A Biomechanical Cadaveric Comparison of Three Fixation Methods for Bennett Fractures Seth A. Ahlquist, Erika Hookasian, Christopher R. Gajewski, Binglong Lee, David J. Graham, Brahman S. Sivakumar, Neil F. Jones, Edward Ebramzadeh, Sophia N. Sangiorgio 10.1016/j.jhsa.2025.10.021 Journal of Hand Surgery (2025) 2025-12-13 Journal of Hand Surgery 2025-12-13 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00576-3/fulltext?rss=yes Anterior radial head instability may persist with anatomic restoration of the ulna in anterior Monteggia fractures, leading to poor outcomes. The purpose of this study was to evaluate the effect of apex posterior ulnar overcorrection on radial head (RH) stability in the setting of anterior Monteggia fractures. It was hypothesized that increasing apex posterior angulation of the ulna, as well as a supinated forearm position, would decrease anterior RH translation. Apex Posterior Overcorrection of the Ulna Increases Radial Head Stability in Anterior Monteggia Fractures: An In Vitro Biomechanical Study Kirk Vannitamby, Carlos Prada, Cole T. Fleet, James A. Johnson, Graham J.W. King 10.1016/j.jhsa.2025.10.010 Journal of Hand Surgery 51, 8 (2026) 2025-11-27 Journal of Hand Surgery 2025-11-27 51 8 S0363-5023(26)X2006-8 Fracture/Trauma: Curated by Stephen Tham 865.e1 865.e8 https://www.jhandsurg.org/article/S0363-5023(25)00575-1/fulltext?rss=yes To report the effect of the bridge-combined internal fixation system to achieve simplified ulnar shortening osteotomy in the treatment of ulnar impaction syndrome. The Ortho-Bridge System for Simplified Ulna-Shortening Osteotomy Xiaoqing He, Jianping Zhang, Wenqian Mo, Ying Xiong, Yongqing Xu, Xi Yang 10.1016/j.jhsa.2025.10.009 Journal of Hand Surgery (2025) 2025-11-19 Journal of Hand Surgery 2025-11-19 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00531-3/fulltext?rss=yes To investigate whether a Y-strut configuration of dual headless compression screws provides greater force to failure when compared with a single intramedullary screw (IMS) in the fixation of proximal phalanx fractures. Biomechanical Evaluation of Y-Strut Dual Headless Compression Screws Versus Single Intramedullary Screw Fixation in Proximal Phalanx Fractures Samuel Lie, Philippe Massard-Combe, Sara Sadat Farshidfar, Mohammed Baba 10.1016/j.jhsa.2025.09.016 Journal of Hand Surgery 51, 8 (2026) 2025-10-30 Journal of Hand Surgery 2025-10-30 51 8 S0363-5023(26)X2006-8 Fracture/Trauma: Curated by Stephen Tham 864.e1 864.e6 https://www.jhandsurg.org/article/S0363-5023(26)00459-4/fulltext?rss=yes Journal CME Instructions 10.1016/S0363-5023(26)00459-4 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 A14 https://www.jhandsurg.org/article/S0363-5023(26)00450-8/fulltext?rss=yes Table of Contents 10.1016/S0363-5023(26)00450-8 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 A7 https://www.jhandsurg.org/article/S0363-5023(26)00449-1/fulltext?rss=yes Editorial Board 10.1016/S0363-5023(26)00449-1 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 A4 https://www.jhandsurg.org/article/S0363-5023(26)00448-X/fulltext?rss=yes Masthead 10.1016/S0363-5023(26)00448-X Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 A2 https://www.jhandsurg.org/article/S0363-5023(26)00428-4/fulltext?rss=yes In the Surgical Technique article by Westbrooks et al in the May 2026 issue of The Journal of Hand Surgery (“Arthroscopic-Assisted Scaphoid Nonunion Repair”, Vol. 51, No. 5, p. 524.e1-524.e13), there were errors in Figures 4 and 6. The illustrations of the distal portions of the scaphoid was flipped 180°. The correct figure parts are as follows. The authors regret this error. Erratum 10.1016/j.jhsa.2026.05.017 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 Erratum 927 https://www.jhandsurg.org/article/S0363-5023(26)00323-0/fulltext?rss=yes We thank Afshar et al for their thoughtful comments and interest in our article. We appreciate their emphasis on the potential role of the dorsal scapular nerve (DSN) in scapular dysfunction among patients with neurogenic thoracic outlet syndrome. Response to Letter to the Editor “The Association of Long Thoracic Nerve Variants With Medial Scapular Winging on Thoracic Outlet Syndrome: A Clinical and Anatomical Study” Madi El Haj, Shaul Beyth, Robert R. Hagan, Sofia A. Vorobeitchik, Harvey Chim 10.1016/j.jhsa.2026.04.018 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 Letter to the Editor e13 e14 https://www.jhandsurg.org/article/S0363-5023(26)00322-9/fulltext?rss=yes I read with great enthusiasm the article “The association of long thoracic nerve variants with medial scapular winging in thoracic outlet syndrome: a clinical and anatomical study,”1 published in your distinguished journal. The authors retrospectively investigated the prevalence of preoperative medial scapular winging and dyskinesia in patients with neurogenic thoracic outlet syndrome (TOS) and examined its correlation with anatomical variations of the long thoracic nerve (LTN) relative to the middle scalene muscle. Letter regarding “The Association of Long Thoracic Nerve Variants with Medial Scapular Winging in Thoracic Outlet Syndrome: A Clinical and Anatomical Study” Ahmadreza Afshar, Ali Tabrizi, Mohammad Javad Shariyate 10.1016/j.jhsa.2026.04.017 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 Letter to the Editor e11 e12 https://www.jhandsurg.org/article/S0363-5023(26)00311-4/fulltext?rss=yes We appreciate the commentators’ interest in our study “Early postoperative complications following partial distal biceps tendon surgical repair,”1 but respectfully disagree with several of their assertions. Response to Letter to the Editor Regarding, “Early Postoperative Complications Following Partial Distal Biceps Tendon Surgical Repair” Lilah Fones, Pedro K. Beredjiklian 10.1016/j.jhsa.2026.04.006 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 Letter to the Editor e17 e18 https://www.jhandsurg.org/article/S0363-5023(26)00254-6/fulltext?rss=yes We read with great interest the article by Benuzzi et al1 documenting pain interference in young adults with brachial plexus birth injuries (BPBI). As the United Brachial Plexus Network (UBPN), the leading national nonprofit organization dedicated to supporting individuals and families living with BPBI, we commend this work and write in strong support of its findings. Letter to the Editor Regarding “Pain Interference in Young Adults With Brachial Plexus Birth Injuries” United Brachial Plexus Network, Evan J. Hernandez, Christopher Janney, Jordyn Whiting, Jennifer Wingrat, Kyle Harris, Kimberly Walker 10.1016/j.jhsa.2026.03.018 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 Letter to the Editor e15 https://www.jhandsurg.org/article/S0363-5023(26)00253-4/fulltext?rss=yes We read with interest “Early postoperative complications following partial distal biceps tendon surgical repair” by Fones et al.1 We have several concerns regarding the publication of this study, its methodology, and conclusions. Our major concern is that this type of publication normalizes surgical intervention of distal biceps tendinopathy (often misleadingly referred to as “partial tear”) when surgery is decidedly optional and nearly all enthesopathies and tendinopathies resolve without operative treatment. Re: Early Postoperative Complications Following Partial Distal Biceps Tendon Surgical Repair Lee M. Reichel, David Ring 10.1016/j.jhsa.2026.03.017 Journal of Hand Surgery 51, 8 (2026) 2026-08 Journal of Hand Surgery 2026-08 51 8 S0363-5023(26)X2006-8 Letter to the Editor e16